Most of our services are provided at no charge due if we are named your agent of record!!

What can we do for you?

Simply fill out and submit the form below to give us an idea of your priorities,
or contact us using the information at the bottom of this page.

Service Checklist

In the section below, rate the importance to you of each of the following services (10=high, 1=low), and check the box if they are provided by your current agent:

Service	Importance	Your Agent?	eBenefits Group?
On-line Benefits	10 9 8 7 6 5 4 3 2 1		Yes
On-line Human Resources	10 9 8 7 6 5 4 3 2 1		Yes
On-Line Risk Management	10 9 8 7 6 5 4 3 2 1		Yes
COBRA Administration	10 9 8 7 6 5 4 3 2 1		Yes
Voluntary Benefits	10 9 8 7 6 5 4 3 2 1		Yes
Labor Relations Legal Assistance	10 9 8 7 6 5 4 3 2 1		Yes
Payroll On-line	10 9 8 7 6 5 4 3 2 1		Yes
Electronic Enrollment	10 9 8 7 6 5 4 3 2 1		Yes
Employee Insurance Manuals	10 9 8 7 6 5 4 3 2 1		Yes
Employee Handbooks	10 9 8 7 6 5 4 3 2 1		Yes
Customized employee benefits statements	10 9 8 7 6 5 4 3 2 1		Yes
Day to day customer service and problem resolution	10 9 8 7 6 5 4 3 2 1		Yes
Employee personal resource guide	10 9 8 7 6 5 4 3 2 1		Yes
Workers comp claim management	10 9 8 7 6 5 4 3 2 1		Yes
On-line job postings	10 9 8 7 6 5 4 3 2 1		Yes
Enhanced "electronic" employee communications	10 9 8 7 6 5 4 3 2 1		Yes
Safety training requirements	10 9 8 7 6 5 4 3 2 1		Yes
State mandated benefits updates	10 9 8 7 6 5 4 3 2 1		Yes
Renewal Negotiations	10 9 8 7 6 5 4 3 2 1		Yes
Detailed Market Research and savings analysis	10 9 8 7 6 5 4 3 2 1		Yes
24 by 7 Benefits for employees	10 9 8 7 6 5 4 3 2 1		Yes
Section 125 savings analysis	10 9 8 7 6 5 4 3 2 1		Yes
Key employee insurance evaluation	10 9 8 7 6 5 4 3 2 1		Yes
Financial contribution analysis and insurance budgeting	10 9 8 7 6 5 4 3 2 1		Yes
OSHA Requirements and updates	10 9 8 7 6 5 4 3 2 1		Yes

Important Questions

In the section below, list your most important questions, concerns or issues regarding your company benefits situation:

Company Information

Company Name:

Contact Name:

Contact Title:

Mailing Address:

Telephone:

Fax:

E-Mail

Preferred Contact Method:

Select one: Phone E-Mail Fax

Number of Employees:

Current Benefits Package:

eBenefits Group Northeast, LLC

1008 Main Street Branford, CT 06405
voice 203.488.2688 * fax 203.483.9912

30 Mill Street, Unionville, CT 06085
voice 860.675.4227 860.673.2207

Principal Members:
Gary A. Dunn

John L. Hodson

Stephen Repka, III

Robert S. Ford

Darlene L. Kish-Thomson